Comparison of prevalence of pain symptoms and completion rates using a patient-reported outcomes (PRO) tool of pain in palliative and curative patients.
Bibliographic record
Abstract
78 Background: Regular self-reporting of symptoms using validated computerized assessment tools can improve individualized symptom management. Yet there are concerns that palliative patients who may benefit most from such self-reporting may be reluctant to adopt such approaches or have barriers to proper reporting. We compared actual prevalence and completion rates of a PRO-tool between patients being managed with a palliative (PAL) or curative intent (CUR). Methods: A pain PRO-tool was administered cross-sectionally using tablet technology across outpatient clinics in a comprehensive cancer centre. Questions were adapted from the Brief Pain Inventory (BPI) and Edmonton Symptom Assessment System (ESAS), recording responses on pain severity and interference in life. PRO-tool completion rates and prevalence of pain symptoms were compared between CUR and PAL. Results: Of 200 patients, 82 were PAL and 118 were CUR; median age was 60 (21-86) years; 48% were female. A greater proportion of PAL were found with gastrointestinal, gynecological and lung cancers than CUR (p = 0.04). Each question had greater than 95% completion rates for both groups, capturing a wide range of scores. 16% of PAL reported no pain as their worst pain in the last 24 hours as opposed to 31% of CUR (p = 0.02). 82% (PAL) and 68% (CUR) reported their average pain as being at least “some pain” (p = 0.03), and there were no differences in the proportion of patients reporting interference with their general activity between PAL and CUR (p > 0.05). Presence of current pain was equivocal when assessed via the ESAS adapted question (76% PAL vs 66% CUR, p = 0.16), but was significantly different when assessed using the BPI adapted question (72% PAL vs 56% CUR; p = 0.02). Conclusions: A Pain PRO-tool was completed with similarly high rates in PAL and CUR patients. As expected, prevalence of recent and current pain was high in both groups, and in some instances, higher in PAL than CUR patients. These results suggest that a Pain PRO-tool could be implemented with ease in the palliative setting, and would capture pain comprehensively.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".